Inpatient Coding Validator I — Quality & Compliance

Beth Israel Lahey Health; United States; On-site; USD 40,000 - 64,000; Full time

Job summary

Beth Israel Lahey Health is seeking a Coding Validator I to join our growing team. Under the Director of Coding, you will perform quality reviews of inpatient records to validate ICD-10-CM/PCS, CPT, DRG or APC appropriateness, identify missed diagnoses, and support accurate reimbursement.

You will collaborate with the HIM team to ensure coding uniformity, provide feedback to staff, and participate in system testing of 3M coding software and the EHR.

Qualifications

• Education: Associate degree in Health Information Management or AHIMA/AAPC certification required.
• Licensure/Certification: RHIA, RHIT, or CCS; CIC from AAPC required.
• Experience: Minimum 3 years inpatient ICD-10-CM/ICD-10-PCS coding.
• Skills: medical terminology, MS Office, knowledge of ICD-10 guidelines, strong written communication, and EHR knowledge.

Responsibilities

• Performs pre-bill inpatient audits to ensure compliant coding and payer interpretation.
• Provides educational feedback on coding and reimbursement changes.
• Performs Patient Safety Indicators and Hospital-Acquired Condition reviews.
• Performs focused DRG audits and supports coding accuracy.
• Writes compliant retro coding queries to providers when indicated.
• Collaborates with CDIS and clinical staff to improve processes.
• Tests systems related to 3M coding software and EHR.
• Attends meetings and pursues ongoing professional development.
• Serves as coding resource for other departments.

Skills

Medical terminology

Excel

Word

PowerPoint

ICD-10-CM

ICD-10-PCS

CPT coding

EHR systems

Written communication

Data management

Education

Associate degree in Health Information Management

AHIMA or AAPC coding certification

Tools

3M Coding Software

Electronic Health Record (EHR)

Job description

Beth Israel Lahey Health is seeking a Coding Validator I to join our growing team. Under the Director of Coding, you will perform quality reviews of inpatient records to validate ICD-10-CM/PCS, CPT, DRG or APC appropriateness, identify missed diagnoses, and support accurate reimbursement.

You will collaborate with the HIM team to ensure coding uniformity, provide feedback to staff, and participate in system testing of 3M coding software and the EHR.